The Pennsylvania Supreme Court has ruled on the case of Reginelli v. Boggs in a 4 to 3 vote affirming a prior court decision that an outside contractor to Monongahela Valley Hospital (MVH) known as Emergency Resource Management Inc., (ERMI) is not a state-regulated health care provider. EMRI had sought to maintain that key peer review documents they had were shielded from discovery according to the Peer Review Protection Act (PRPA), which provides protection for information used by those who report to a review group. The Court concluded that peer review documents are only privileged when generated by formally regulated medical providers.
The point of contention involved the disclosure of a file containing a performance report of Dr. Marcellus Boggs, who was employed by ERMI. Justice Christine Donohue explained that the majority interpreted the statute to relate only to entities “approved, licensed or otherwise regulated” for healthcare practice. The majority did not dispute that the PRPA does promote that assessments of medical practitioners be conducted by their colleagues, who are the best qualified for this role. This is similar to the role of an expert witness in claims of medical malpractice; another provider from the same medical specialty is best suited to interpret whether a provider adhered to practical standards.
This was a case of medical malpractice alleging that Dr. Boggs was negligent in treating plaintiff Eleanor Reginelli for chest pains, leading to a permanent heart condition. Reginelli's counsel sought discovery of peer review documentation written by Dr. Brenda Walther, another ERMI staff member, and supervisor of Boggs'. The Washington County Court ruled that these records were not considered to be privileged after the defense sought PRPA protection.
The defense next argued that the documents were shielded from discovery because they were created specifically as a performance review. In addition, the defendants said that ERMI's peer reviews were conducted based on provisions in their contractual agreement with MVH. The court denied these assertions as well. They questioned why, in prior lower court testimony, ERMI had stated that the performance reports were created exclusively for their internal use and why MVH had not received the reports if they for the hospital's benefit.
After the trial court had ordered that Boggs' performance file be presented, the case when through a lengthy appeals process. The Superior Court upheld the trial court's ruling, also finding that the documents were generated for ERMI's usage. Another ruling that hurt the defense was that ERMI was considered to be an independent contractor, which is not a classification that is eligible for PRPA protection from disclosure.
In the post-ruling discussion, a prevailing attorney expressed how the ruling of the court, in this case, will provide significant guidance in future cases. He explained that clarification of the rules for determining eligibility according to the PRPA will definitely benefit lower courts. Further, he commented that in malpractice cases “transparency should make the care better and safer” for all patients.